In this state was (and probably still is for the most part) a dehumanized medicine. During the communistic regime, it was appropriate to work in pregnancy, after birth stop breast-feeding as soon as possible (maybe in three months, if I remember) and put the child into a creche, in daytime, to be able to work again.
The pregnancy and birth was treated like a disease. It took place in hospital, in the surgery room, with strong lights, with lots of people around, with nobody caring to calm their voice. The baby was took out, hanged by head down, smacked on it's back, and not given any time to spend with mother to form a bounds, often it was separated for days, for medical observation, weighing, immunization, and so on. Some hospitals boasts, how soon after birth they return the child to mother. Well, there is nothing to boast with, as they take them apart, in the first place! Other practices were also humiliating, if not misogynic. No privacy, shaving and clysms before the birth, no birth in a natural position (when a gravity helps it) and so on. I know that such things are considered necessary, but still it's nothing I'd wish the woman and child.
As for the immunization, that's a controversial thing. Some people says, that so early immunization is dangerous to the child. It seems like a common sense, that it isn't good to inject the body with an army of deadly bacteries in retirement, when it's not even nearly finished. The early vaccination is blamed for problems like allergia, dyslexia, dysgraphia, dyscalcullia, ADHD, and so on. I would personally decide to delay the immunization as long as possible.

However, I don't know if such a law is still here, but I had read something about it several years ago. It was about a compulsory vaccination of newborns, every rejected vaccination is punishable by a sum of 10 000 CZK (500 dollars), which is about my monthly salary and absolutely devastating sum for a young family. Such a family thus gets into a serious debts, can't pay their bills, can't take care of children, children are taken from them and put into a state care, and the family is destroyed. Just because they refused to participate on the state-enforced vaccination business. You see, the mafian ransom collectors have a lot to learn.

So obviously, I would strongly prefer an alternatives to obstetrics, like midwifery (birth assistant), birth houses, pre-birth exercises and preparation, and so on. In case of predictable diffculties with the birth, a doctor and a hospital would be necessary. In such a case I'd prefer an intelligent and caring doctor, who has some respect to the woman and doesn't just pull out the foetuses. Of course, the doctor or midwife must be educated in medicine and anatomy, that's obvious, I hope.

But what's actually the scientific treatment in pregnancy? The kind of obstetrics I described seems very sophisticated and technologic, but it's not scientific at all. The child is accustomed to a dark, cramped, warm, soft and silent environment, and is harshly pulled out into a sharply enlightened, vast space full of noise, is wrapped into a sand-paper-like towel, and separated from the mother. This must produce a great shock, which is a reason why so many people has a problems like migrene in their later life. My mother did a lot of regression therapy sessions with taking the client to a moment of their birth, where the problem was, the so-called scientific birth, which rather resembles a butchery.
The real scientific birth is more simulating the actual environment in womb, the low lights, warm air, silence, maximal privacy and minimal stress, no crowd of medical staff around. Alternatively, a birth in water pool is also an interesting choice, providing maybe even better circumstances.

A knowledge of traditional midwives may not be entirely unscientific, after all. There was a habit to give the woman a smell of a sweated man's shirt. Reputedly, some scientists observed, that a feromones in male sweat started to produce some hormones in woman's body which made the birth more easy and less painful. Thus, the presence of a husband at birth may be a good idea, or at least harmless and psychologically encouraging for the woman. Yeah, that's another thing which the local communistic medicine didn't like.
 

Here's my 2 cents.  I think what you are seeing is a situation with a pretty bad history that has made progress for the better.  Talk to your mother about her birth experience(s) and compare that to what you and your wife have experienced and you can see how doctors have gotten a bad reputation.  There has been a tradition of intervention when it was not necessary in order to make a birth conform more closely to some medical ideal of how it should go.  In reality, a birth can go many different ways and still be fine.  It's often better to take a hands off approach and allow the woman's body to manage the birth process rather than to actively intervene.  There are most certainly situations when intervention is necessary.  However, the approach of intervening only when truly necessary is relatively new in modern medicine.

Also, given that most doctors were men and women were not encouraged to obtain much education, what a woman had to say was not listened to very well.  The doctor knew better.  When you're trying to pop out a kid, being ignored and just told to obey isn't going to go over very well.  Fortunately, this has changed in most places, but old attitudes often linger in some places.  And pregnancy is natural and not disease.  It doesn't need to be cured, but helped along.  Yes, there can be fatal complications.  In those cases you do need to have the active management a fully trained physician can provide, but that is not how the majority of births go.

Finally, there is also a question of resources.  Doctors are expensive, and rightly so.  They have put more time and effort into learning more about the body as a whole than a midwife.  Sometimes that knowledge is needed, but often it's not.  An educated midwife specializes in how the body deals with birth.  She is generally more than knowledgeable enough to help a woman through the process.  She is cheaper and the doctor is not spending time on a routine birth when their expertise could be better utilized elsewhere.  Midwives make a great 1st line of medical care for childbirth.  We do still need doctors to attend to some births, but not as many as do now.

You will obviously find wackos at either extreme advocating that all births be attended to by midwives or all by doctors, but I get the feeling the medical community as a whole is transitioning more towards an educated midwife supported by doctor model.  Maybe that's just here on the West coast though.  Did you or your wife ever check out any midwives or non-traditional birthing centers when planning for the birth?

(Thanks for the topic!  Video games and blowing shit up are fun, but it's nice to read about something else for a change.    )

Here's a link to a google book on feminism and midwifery. I think you'll find Box 4.1 on page 45 of interest:

Pregnancy, Birth and Maternity Care: Feminist Perspectives

There is no debating your excellent points. Historically, the fate of women at the hands of obstetricians was appalling. And I would argue that there is enormous scientific data supporting the non-interventionist management of pregnancy which is exactly what my spouse went through. My argument is that in our current age, the field of Obstetrics is based on scientific evidence. A medical student learns in detail reproductive physiology, biochemistry, anatomy, pathology, pharmacology, pathophysiology and clinical medicine. Do they learn all this purely to detect when something goes wrong in pregnancy? Is a medical student therefore less empathetic than a midwifery student? Don't get me wrong. I'm all for the practice of Midwifery just I am in full support of Nurse Practitioners and Physican Assistants who align themselves with physicians. My critique is that Obstetrics of today is considered dehumanizing because of scientific reductionism and Midwifery is humanistic because it is "holistic" or even "spiritual". And as an atheist, I think any health practitioner (nurse, physician, midwife, etc..) should be well versed in science.

Let's put in in a different context. Suppose you are being managed by an empathetic and caring health care professional. That individual is in touch with your feelings and approaches health in a holistic fashion. Also that person believes the earth is flat and that angels assist in your health care. Would you as an atheist continue that relationship? Or would you feel more comfortable with someone who knows their field and has a strong scientific background?

Hamby, after much effort, I can't seem to cut and paste the appropriate tables and passages from the document. On my google, I'm able to view those pages.

In regards to your statement on feminism, I completely agree. There are probably more feminisms as there are flavors of ice cream. I agree that Ayn Rand could be considered a feminist. I even agree that our gorgeous busty RRS co-founder Kelly O'Connor could be a "feminist". What I am referring to is mainstream feminism that you'll likely find in Ms. Magazine or the folks at www.feministing.com/.

Some feminists despise the fact that doctors deliver children. When I unfortunately had to take a genders studies class at my university (which was just a class on baseless feminsit dogma and nothing more) I did learn about how feminists really don't like it that midwives have been largely replaced by doctors. We read "Exorcising the Midwives" by Barbara Ehrenreich to learn a little about this. "Exorcising the Midwives" is an article rather than a book, so if you can find it online you can read about why Barbara doesn't like doctors.

I think someone here mentioned something about feminists (I'm talking about the feministing.com angry/bitter type) not liking science. In my gender studies class we spent maybe a fourth the time hearing a constant assault on science as being a biased, Western and masculine epistemology that can not be trusted. We read "The Egg and the Sperm" by Emily Martin which is an article about how biology textbooks distort their descriptions of reproduction in order to make it seem like eggs are feminine and sperm are masculine. Total bullshit. The excerpts that they show in "The Egg and the Sperm" are simple, factual descriptions of eggs and sperm, but feminists hate them because they were produced by western masculine science. That class was a waste of my time, and angry feminists need to stop assaulting modern science.

For the record, my mother is unable to give birth and required caesarians to deliver me and my brother. Had she been stupid and had a midwife in her home rather than go to a hospital, both her and I would have have died. Hell, she even told me that her heart stopped during the procedure and that they had to revive her. Thanks to, as my gender studies professor would call it, Western masculine science, I am able to be alive.

And Luminon: one thing that bugged my in your posts is that you keep claiming that the womb is silent. I remember reading that it is quite noisy in the womb. Infants hear their mother's pulse constantly. I remember reading that it is about as loud as a vacuum cleaner inside of the womb.

Some feminists take on dogma that they run with and spend time creating new irrational precepts for us to shake our heads at, for sure.  However, getting rid of midwives was a bad deal.  Women were then forced to go to doctors who often ignored the concerns of the women, dehumanized what to many men and women is a very special event, and turned the focus of childbirth from a somewhat community oriented event to something that focused more on fees and profit.  A trained midwife is all that is necessary for most births.  Obviously, some births (like your mothers' ) do need medical intervention and should be attended to by a more fully trained medical professional. 

National Geographic just had an article on midwives in India that goes more in depth into just how important widwives can be within a community that you may find interesting.  The help these women provide lies more within their ability to navigate community politics and know when they do need to get the help of a doctor than in the medical training they do have, not that I am trying to discount that aspect of what they know.    http://ngm.nationalgeographic.com/2008/12/community-doctors/rosenberg-text

I would be careful in dismissing the anger behind some of feminism so casually.  When the power over your body has been taken from you it creates a very powerful anger.  Now, of course, anger can be misdirected, but there is good in using that anger to affect change.  Yes, some feminist based material is rather crazy, but much of it is a 1st step at trying to solve millenia of oppression.  Good modes of change come from trial and error over time, not brilliant ideas conceived at the outset.

In all fairness, I think you may have a slightly rosier view of the history of midwifery than is warranted.  We westerners tend to romanticize small European style villages with little hearths and kettles and families huddling together for mutual support.  You'd be hard pressed to find many times in history when the family was more involved in births than since the invention of modern medicine and hospital births.  Most of what we popularly think of as "simpler," more natural times were restricted to the very, very well off, if they existed at all.

The simple fact is that most people throughout history have been tremendously poor, and life has been a lot more about just getting through the day than forming loving, self-actualizing bonds between extended family members.  Consider that even within the last three or four centuries, marriages built around idealized love have been the exception to the rule.

When this has happened, it was not a problem with doctors, but a problem with the system in which doctors worked.  I know someone who photographs births and creates birth albums for new parents.  When I see these albums, I'm seeing families together, experiencing the birth as a family.  Sure, there are impersonal doctors, but don't kid yourself.  There were impersonal midwives, too.

While we're on the subject of midwives, did you know that midwives were the legal loopholes for infanticide?  It was common practice for families who couldn't afford more children to have midwives who would take a child into the other room and then "discover" that they had died suddenly and without explanation.  Let's also not kid ourselves about the very great temptation for biased or bigoted midwives to practice their own form of natural selection to suit their own tastes.

I don't know about you, but I'll trade a safe medical environment and constant attention from a real doctor for my own cushions, and if it comes down to it, if I need my family to be around me at the hospital, they can pony up for a cab.  I just don't see any rational reason to have less than the best qualified person around for an event with so many potential complications.  Isn't a little bit of impersonal treatment worth knowing that you have the best possible chance of having a healthy child?

I'm sorry, but all of this sounds like emotional pleading without substantive content.

India, especially rural India, is very much like pre-industrial Europe in many ways, and it is also subject to the same problems.  Sure, midwives can navigate community politics, but there's no reason to expect that they won't also navigate their own personal politics.  Every system has its problems.

You know I'm all about justified anger.  I would be very careful throwing around words without being really sure that they're justified, though.  Better to correct misplaced anger before it leads to bad social change, or so it would seem to me.  

I found this attitude a problem in general with the public's perception of medicine. I am a practicing physician and I will be the first to acknowledge that Medicine is an imperfect science. It will never be equal in stature to say classical physics or chemistry. But allopathic medicine is based on the philosophical doctrine of reductionism and this is what gets peoples' goat. In our time, both from religion and non-religious groups there is a pervasive anti-science which unfortunately has permeated the mindset of feminists. And paradoxically, were it not for feminism we would not have brilliant women in science and medicine.

There is a distaste for reductionism particularly in biology and in medicine because whether we like it or not, we are all a collection of interacting cells. And each cell is the result of a complex biochemistry. There are even many atheists who find this view repugnant. And in medicine particularly in fields such as Obstetrics, there is a vocal opposition to any form of reductionist thought particularly when this leads to caring for a pregnant woman. I know feminists will consider this statement misogynistic but it is a statement of fact. A pregnant woman and her fetus are a collection of cells. All human beings are a collection of cells. And the foundation of medicine is understanding the cell. Hail to Virchow.

But here is what the opposition totally fails to grasp. Isn't it truly a feat of nature as to how those cells interact to create what we call human. Isn't it fascinating as to how an incredibly large collection of cells interacting in an electrochemical manner results in a mind. Only a very few (me included) are blown away in awe at this.

It is reductionism in medicine that people dislike and and yes in part because of bigotry. Despite the fact that much of our history is tainted with misogyny and racism, there has been great scientific work that has led to modern medicine.

The French Neurologist Paul Broca discovered a region in the dominant frontal lobe that results in an expressive aphasia when damaged. But Paul Broca had racist views of human cognition. There are countless examples similar to this. Should we therefore scrap Broca's aphasia because Paul Broca was racist. Instead of a Neurologist, why not send those patients with such a language disturbance to a caregiver who is anti-reductionist and denies the existence of discrete neural regions devoted to speech because of the racist history of Neurology. Why don't we just scrap Neurology and Neuroscience altogether.

And while we're at it, let's go further and deny biostatistics because it is the product of the eugenics movement. And therefore, we must scrap clinical trials. Let's deny transistors because Shockley was a racist. That's right all of you who are working on your PCs right now must destroy your computers because they are likely infested with racist transistors. Or maybe if your computer crashes you could take it to a holistic computer repair shop that denies the existence of transistors.

If you can find it, I would recommend reading this article. It is the best example of anti-science feminism that I have ever seen. The worst part about reading that article was discussing it in class with other students. It seemed to be that I was the only one that didn't accept the baseless dogma presented in it. Other students agreed with Emily Martin that the biology book excerps shown clearly try to impose cultural views of what it means to be female onto eggs and what it means to be male onto sperm. Of course every quote in the article from a biology textbook merely gives a plain description of a human egg or sperm. Since I was the only engineer in that class (it only had about 30 students) and since the class had no scientists in it, I was the only voice of reason. It still makes me sad that I was the only student in class that didn't accept the article's claims as fact.

DG, I see no problem in there. Our high percentage of vaccinated population allows us to withstand quite safely some immunitary parasitism. Thanks to the vaccined children all around, it is possible to delay the vaccination, if the parents are afraid what it would do to a newborn baby. There is no-one around who could catch or spread small-pox.
Did you ever wonder where did children today get these very high rates of dyslexia, ADHD, congenital defects or allergies?
I'd say that environmental pollution for the most part, but you can't blame the parents for sparing the child one less dose of potentially dangerous liquid, until they grow up a little.

There was an administrator of nursery school in TV, who refused to have an unvaccinated child in her daily care. The argument was, that "other children could get infected."
You see there is a bit too much hysteria about it.

They just spent their time being miserable. Now days we have the options of taking anti-allergy pills, but back then people just had the allergies and could do nothing about it.

Also: did you imply that vaccinations give ADHD and dyslexia? Come on, Luminon. We both know that is nonsense. That is as wrong as the people who say that vaccinations cause retardation. In the US that is the lie people use to try and convince others that vaccinations are bad: that vaccinations make children retarded.

From what you described, I see no distinction between obstetrician and midwife. What you described is analogous to a nurse practitioner or physician assistant who is working under the supervision of a physician. The monitoring and data collection is utilizing the methods of science for the care of mother and fetus. Like I said before, any health practitioner that fully respects science and strips their care of any spooky holistic/spiritual crap is truly maintaining the integrity of his/her profession. Once again, if an obstetrician does not provide emotional support and non-judgemental attention then that individual should not have graduated from medical school. The only possible distinction I see in the clinic you described is that the obstetrician likely has to care for multiple pregnant women and may not be able to devote enough time to a particular individual. Whereas, the midwife may have fewer. In this regard, for the sake of the woman's emotional comfort requiring the constant attention of a caregiver, I would give 100% support to a clinic in which doctors and midwives co-manage in a collegial manner.

 Just to be really clear, I have no objection to births at home.  If you scroll up, you'll see where I said that it's great if you can afford it or happen to be tight with someone who'll do you a favor.  What I object to is giving women less than good care in the name of homeopathy or "natural" childbirth.

I think if we're going to be fair we have to separate the midwives of old from the nice if slightly hippiefied candle burning trained practitioners of today.  In most European villages before the industrial revolution, a midwife was your only option if there was to be an attendant.  Please remember that there wasn't even a midwife available all the time.  Many women gave birth without anyone to help besides her husband (if he hadn't left her -- abandonment was very common in the working classes) or children (who certainly weren't trained in obstetrics.)  Let's not pretend like we really think every woman had a gray haired wisened mother to help.  Many of their mothers were long dead from childbirth, which ranked up their with the black plague as one of the number one killers of women.

Please, let's not romanticize the past to the detriment of the present.  The most uncaring doctor in a hospital is at least twenty steps up from dying in childbirth or causing serious problems with the baby.  So, just to make sure I'm coming through loud and clear, I have no issue with home birth if the birthing assistants (no matter what we call them) are trained in obstetrics.  But I refuse to say that just because it's birthing, or that it's a female thing, that it's ok to have less science.

That's special pleading, and it's a fallacy even when it's about women giving birth.

No.  Midwives were certainly beneficial on average, if only because a person who isn't currently pushing a watermelon through a garden hose is much better equipped to handle emergencies.  In fact, I'm reminded of a piece of data I read about an outbreak of the plague in which a certain sect of Christianity fared substantially better than the surrounding country (I wish I could remember when this was... it's so foggy in my brain right now... it doesn't matter, though).  Of course, God was given all the credit, but it was much simpler than that.  For whatever reason, this particular group of Christians believed that God wanted them to keep plague victims as cool as possible and give them water.  In the surrounding country, the treatment for the plague was banishment outside of the city.

The Christians were right for the wrong reasons, but duh... they had a much better survival rate.

To call someone a doctor before about 1850 is to do a disservice to the modern meaning of the word.  Sure, they had a few things right, but for the most part, they were good at cutting off limbs and prescribing mercury and leeches.  All the history I've seen indicates that the main thing about having a doctor or a midwife present was that somebody was present and responsible for helping.

Without question, though I hardly see why the comparison is relevant.  You wouldn't suggest going to a 1700s doctor for anything else, either.  See what I'm getting at?  Comparing to the past is useless.  We have knowledge today that we have never had before, and any comparison between midwives of the past and doctors of today is meaningless.  All we can do is compare hospital births to midwife births today.  If the training and care are the same, great.  If they are not, then it's a bad idea.

I can agree with that.

I'm not sure I totally agree with this.  Correlation isn't causation.  Remember, we let women teach in schools through some of the worst of our misogynist periods.  I think a little more digging might point more towards economic considerations than blatant sexism.  I'm not saying men weren't sexist during industrialization.  They were.  However, you have to remember that doctors were always men before, and the driving force behind hospitals was not an attempt to make women less meaningful in society.  (It wasn't as if they had much meaning out of the house anyway.)  It was an attempt to make things more efficient, more modern, and more like an assembly line.  That's what industrialization was all about.

Think about it another way.  Without thinking gender for a minute, think of all the jobs that were made obsolete by the industrial revolution.  Most of them were mens' jobs because most jobs belonged to men.  When we line up all the jobs that became obsolete between 1850 and 1950, we find that men were the main victims of technology.  Women get upset because midwives were one of the only respectable things they could be, but I can't find any historical evidence that the decision was primarily sexist.  This, in a nutshell, is what I think is the worst sin of feminism -- cherrypicking history to make things look sexist when they were not (or at least were not primarily).

If I'm wrong on that, I'll certainly recant.  This is not my specialty, but I've certainly read enough history to feel like I have a decent grasp on it.

Like... being an obstetrician.

I don't think you really answered my question. Let's set aside the midwife/obstetrician. Would you in general see a homeopathic health provider? For if you do, then you are accepting the supernatural and abandoning all science and reason for the sake of "better" care. I get the sense that the ultimate motivation for midwifery over obstetrics among the masses is the supernatural. It seems as though many women want spirituality from a midwife and not the science of medicine.

I can only argue from personal experience here, but I don't think this is true.  I do know one woman who would ignore the science entirely and just look for some spiritually based new age whatever.  However, she truly is just 1/2 a step away from being committed to a mental institution.  Most women I've interacted with want a method that combines the medical knowledge we have available with an acknowledgment that birth is a life event that is special and does have an emotional component for them and their family.  They want medical intervention if it's needed, but they want the focus to be on the life event portion of birth to be primary if medical intervention is not necessary.  This would include women who are not very well educated and those with some education (defined as 2-4 years of college with a degree completed) .

Porkchop, given your job I'm sure your experience is much more relevent than mine.  Is this just what I'm seeing within my circle of acquaintances, or is this what you have found to hold true for a good portion of the women you see too?

Ragdish, is this an attitude you say in the other women in your wife's Lamaze (or whatever other similar) classes, or something you've found from research online?

If anyone truly accepts the notion that diluting a substance to micro parts per million will increase its efficacy is just one step away from accepting intelligent design or the believing in the celestial teapot. If homeopathy isn't supernatural than neither is believing that Elvis is alive and works at a 7-11 in Knoxville, Iowa.

This all stems from the broader public dislike of modern medicine with the rise of alternative therapies to be found in homeopathy, shiatsu, naturopathy, etc.. and of course, faith healing via prayer.

I hate it when people equate natural with health, just like when people call vegetarian diets ' healthy ' diets. Pretty much everything we use is ' natural '. Even if we force chemicals to bond artifically, those chemicals appear in nature, and are therefore natural. For that matter, uranium is natural, but I don't hear the new age nut jobs suggesting that you shove a chunk of U-238 up your ass to cure a headache.

At least medically approved treatments are regulated. Crystal waving herbologist dipshits seldom bother to tell their sucker patrons that too much corn silk can cause renal failure, that too much foxglove can stop your heart, and that too much willow bark can cause cardiopulmonary arrest. Street drug chemists show more accountability for the stuff they cut their dope with than the average tree hugging, spirit channeling, bead wearing, snake oil selling new age ' healer '.

< In my best Cartman voice > Goddamn hippies, go take a bath!

Now excuse me while I go chase down an Arctic hare for dinner, rip its throat out with my teeth, and season it with a dash of MSG.

I was referring to your comment, not Ragdish's.  Please forgive me if I've misunderstood what is sarcasm from you as "If this is the argument, then I suggest we eliminate cancer treatment facilities as well.  Have you ever been to one of those?  They're quite sterile and lack all the niceties of home." seemed sarcastic and ridiculing to me.  You're starting to confuse me as you've stated both that you're fine with the idea of home births, but that it is not the best option and therefore you're not ok with it. 

OK?  Then what is "Remember, we let women teach in schools through some of the worst of our misogynist periods.  I think a little more digging might point more towards economic considerations than blatant sexism. " in response to "Much of this was due to a cultural climate in which women and their intellectual abilities were not respected." supposed to be telling me?  Again, I'm a bit confused as to your point here.

I am not looking for cathartic release or whatever here.  I sincerely do not see your point.  Yes, industrialization was a factor in most if not all societal changes seen during the same time midwifery declined.  All of society had to adapt to new ways of living.  Midwives were actively prevented from adapting due to their gender.  The profession almost died out completely because women were actively barred from functioning as professional midwives due to their gender, not market forces.  Industrialization did not bar women from higher education - a sexist mentality within society did.  Industrialization did not look down on the intelligence and therefore the capacity of women to be able to act as professionals - a sexist society did this.  Yes, this all happened within a framework of a society that was becoming more industrialized, but industrialization is not the cause of the decline of midwifery in the same way it replaced artisanal cabinet makers, cobblers, iron workers, etc.  You're right, they were not targeted for their gender, but because their skills were no longer valued in the marketplace.  Midwives did face problems simply beacsue they were women and women were not seen as capable entities.  It was not just a matter of replacing the job with better technology, but of a pervasice societal attitude saying women cannot be involved in something requires technical expertise because they are women and therefore not capable.  That is targetting based on gender.

I see what you're getting at, but I think you possible have not spent as much time thinking about this subject as you have on others.  Cultures most certainly can as have targetted one gender.  Mythology is not gender neutral.  The Abrahamic religions (and the societies that use them) are quite well known for targetting women for scorn and repression. 

Have you ever seen a dog that's been beat?  That dog can still have a number of useful skills, but not have any knowledge of its own worth.  Midwives seem to have played an important role within the communities that had them, but it was a role that was easily dismissed because they were women and women were not seen to be capable of much.  I'm not sure what you mean by the phrase "social facilitator".  They helped women with birth bith physically and mentally.  Today, they help women with birth both physically and mentally.  Of course the specifics involved in this have changed.  The knowledge regarding the physical has changed and the psychological needs have changed as women have changed.  You don't expect doctors of today to behave in the same manner and perform the same functions as doctors of 100-150 years ago.  Why would you expect midwifery to stay in some sort of stasis?

I think the focus is on the best possible method of giving birth.  You and I have gone off on a tangent regarding midwives in the past because we have different perspectives but do both care about how we got in the situation where we are today.  I like history.  I like being able to discuss issues from history with others who are well enough informed to be able to make me question my perspective.  That's why I'm still here.    (I don't get this level of discussion with my 6-year old.  I'm hoping maybe someday, but that's definitely a ways off. )

This has nothing to do with romanticizing the past.  What worked in the past?  What didn't?  What have we forgotten?  What should we avoid?  These are all questions that historical study helps us answer.  We are at a place where women have been dissatisfied with the way births are handled for quite some time and they want better options.  Looking at midwifery in the past does help provide some ideas for how to handle birth in ways that work better for women while also utilizing the best medical technology has to offer.  What exactly do you mean by at home births for women who can afford it?  What is it that you're wanting them to be able to pay for?

Sorry, but I'm actually more confused as to your position.  We do have the same goals, but are approaching the issue from different paths.  I sincerely do not think the problem can be invoked without looking at the history of the role of women in society.  There is a level of mistrust of anything associated with science amongst the general public that is simply appalling.  Do people still use technology?  Yes, but I don't see them trusting scientists or the services those who do understand science have to offer.  They know the results are likely to be beneficial, but they don't know why and they do know they've been lied to before.  Acknowledging the errors of the past does help deal with this broken trust.  Why not use some of the effort that has been put into feminism for good if possible?  Why not use some points from feminism if they are valid?  Would you not use an Islamic critique of Christianity in a discussion if appropriate simply because it is rooted in Islam?  I don't think so.  I think you'd use whatever is true and works.

I really do want to emphasize here that the whole birth experience is not just physical.  I know you understand that giving birth is quite difficult.  What I don't think you are seeing is the link between a certain level of mental preparedness and comfort and how that affects the ability of the women to perform physically during the birth.  Have you ever heard a long-distance runner talk about pushing through "the wall" to be able to finish their race?  I don't know of any other way to describe it but to compare it to that wall.  You have to be able to keep yourself focused and able to deal with the task at hand.  That is not some minor component of birth, but rather a central component.  This is an area where midwives are trained and classically trained obstetricians are not.  This is a good deal of why obstetrics is changing (looking at practices of midwives in the past) and why midwives and doulas are seen more and more as responsible alternative care providers.  It does not mean an abandonment of all that obstetrics has to offer, but a demand that obstetrics offer more. 

I think I've pretty much answered these, but am sure I've forgotten something.  My kid's movie is about to be over so I do need to stop for now.  Please do let me know what I haven't answered and I will get back to you just as soon as I can.  Thanks for being willing to chat.